Sistema de Salut de Catalunya
Institut Català de la Salut
[Vidaur L] Intensive Care Unit, Donostia University Hospital, Donostia-San Sebastián, Spain. Biogipuzkoa, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group, Osakidetza Basque Health Service, Donostialdea Integrated Health Organization, Microbiology Department, Donostia-San Sebastian, Spain. Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. [Guridi A, Leizaola O, Marin J] Intensive Care Unit, Donostia University Hospital, Donostia-San Sebastián, Spain. [Rello J] Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. IMAGINE, UR-UM107, University of Montpellier, Division of Anaesthesia Critical Care, Pain and Emergency Medicine Nimes University Hospital, Nimes, France. [Sarasqueta C] Clinical Epidemiology Department, OSID Donostialdea. Biogipuzkoa, San Sebastian, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-06-16T07:02:34Z
2025-06-16T07:02:34Z
2025-05-05
Biomarkers; Lung microbiome; Severe community-acquired pneumonia
Biomarcadores; Microbioma pulmonar; Neumonía grave adquirida en la comunidad
Biomarcadors; Microbioma pulmonar; Pneumònia greu adquirida a la comunitat
Objetives To ascertain the role of the lung microbiome in the development of severe pneumonia and its potential as a biomarker for disease progression. Methods BAL samples from 34 adults with severe community-acquired pneumonia (CAP) (17 viral, 8 viral coinfected with bacteria and 9 bacterial) admitted to the ICU for acute respiratory failure between 2019 and 2021 were collected within the first 48 h of admission to the ICU. The microbiome was characterized via the Ion 16S Metagenomics Kit and the Ion Torrent sequencing platform. Clinical factors, including survival, mechanical ventilation duration, blood biomarkers and organ failure in terms of acute respiratory distress syndrome (ARDS), shock or acute renal failure, were correlated with microbiome characteristics. Results The microbiome diversity in patients with viral pneumonia was significantly greater than that in patients with bacterial or coinfected pneumonia: the Shannon diversity index was 3.75 (Q1–Q3: 2.5–4.1) versus 0.4 (Q1–Q3: 0.2–1.3) and 0.48 (Q1–Q3: 0.3–1.1), respectively (p < 0.05). The microbiome diversity index was associated with severity-of-illness (APACHE II), independent of the etiology of pneumonia (B coefficient -1.845; p < 0.01). Patients with severe viral CAP who developed ARDS had a lower presence of Proteobacteria, and those who were complicated with ventilator-associated pneumonia had a higher prevalence of Acinetobacter at admission. The mortality of patients with bacterial or coinfected pneumonia was 35%. In coinfected patients, the diversity index was associated with the development of shock. Conclusion Patients with severe CAP have low respiratory microbiome diversity, indicating that respiratory microbiome diversity is a potential biomarker of disease severity.
This study was supported by a grant from the Spanish Ministry of Health, Instituto de Salud Carlos III, FIS17/01463.
Article
Published version
English
Pneumònia adquirida a la comunitat - Prognosi; Marcadors bioquímics; Respiració artificial; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Dysbiosis; CHEMICALS AND DRUGS::Biological Factors::Biomarkers; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis; DISEASES::Bacterial Infections and Mycoses::Infection::Community-Acquired Infections; DISEASES::Respiratory Tract Diseases::Lung Diseases::Pneumonia; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Airway Management::Respiration, Artificial; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::disbacteriosis; COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico; ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones adquiridas en la comunidad; ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::neumonía; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::manejo de la via aérea::respiración artificial
BMC
Pneumonia;17
https://doi.org/10.1186/s41479-025-00163-1
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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